NBME 24 Discussion of the diagnosis with the patient privately (NBME Answers)

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Retired NBME 24 Answers

nbme24/Block 3/Question#13 (reveal difficulty score)
An 83-year-old woman is brought to the ...
Discussion of the diagnosis with the patient privately 🔍 / 📺 / 🌳 / 📖
tags: syphilis ethics repeat

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submitted by ∗peqmd(75)

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iounqste is kngasi sawt'h teh tesb netx etsp tno ssrcyaienel hwat si teh stbe onctgiaisd esp,t hchiw is tmaehswo of Step 2 tanoiotr selfh usioetnq (rfo lpopee who ktase petS 1 faret itsrnoa.)ot L,DRT ebst XENT pste is lakt ot her stifr at mmminiu ouy nede to ietmredne fi hes sah acic.typa

ilehW eth taitpne ash tetrpy dba ME:SM

B. sI the sbte extn .setp uYo nede ot cisdsus whti rhe tifs.r t&=;g rntmeedei erh ioecndis kmnaig yatcciap t&g;= hnet eeprocd hrtwhee to susdcis hwit hre eaghrtud .(A)

aumLrb uurcetpn si teh bets gisdinaoct epst. wr,evHoe in shti tqseinuo 'therye nagski uoy tahw oyu eedn ot od to veen repoedc ot iths p.ste eI.. egt hre pyctiaac nteh ouy can eoceprd to u.ablmr ihTs is ebsueca lraumb uecrtpun si omre aivinvse nda you'll nede ot ssases cacapiyt as wlle as get eihrte reh (if ehs hsa ptc)cyaia or hrgtdue.a

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submitted by centeno(3)

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I tohguht that eth citinvego pnimarietm ulcod be eth asifiaotemtnn of penor.sliiushy nI iti,oandd teh orcodt oshudl altk ritdeylc ot eht pttiane to ekcch rof aexslu esau.b

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j44n ehT mmuaxim EMMS soerc si 03 tos.pni A scroe of 20 ot 24 sgtsesgu ldmi imeed,tan 13 ot 20 sgtgsues maoerted tamnde,ie dan lsse htan 12 tscaniied vreees t.eamneid On ,agveear eht ESMM ocsre fo a esnrop htwi eAresh'mzil edcnlesi tuoab otw to ofru tnsiop aehc ry .ahsee ylon has ldim eintea.md I hda to okol iths pu she cdoul sllti itaren her payictca +1

All patients, including those with dementia, should be assumed to possess the decisional capacity to make medical decisions unless the physician determines the patient does not possess decisional capacity.

+/- namesthegame22(13)

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submitted by ∗lispectedwumbologist(122)

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Cna nybydoa ipalxne sthi no?e I put dteearpe estst ecabsue I ssumdae an eylo8d--r3a wmona si an snuuaul eomcgpharid for psihs.lyi

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m-ice 83 ghimt mees na nmonucom g,ae utb ew od'nt wkon ofr esru erh uxlesa to.hirys eSh nlyo eltnycer (8 hsonmt )oag tasertd oiwhsgn emso nissg fo ldmi ogevicint i.eanmpmitr Seh ahs lal hetes ulretss pimylngi taht esh sha pihl,siys so the otms lliyke aenrsw is ahtt seh ash pshs,ylii os we sulhod kaspe ot rhe raytelvpi tuboa reh aulsex yt.irsho Teh sttse 'ontd yeaecirsnsl enmas hes got plsihiys vrye ,rteecynl ist' bilpsose sesh' dah ylssihpi rfo a lwieh adn venre tog etatre.d +5

mousie I adunetrdsn atth seh lcudo syslopbi vahe ipshslyi btu I olsa tpu pereta sstte beuaecs I wokn ehetr ear a efw sgnhti htat anc easuc fleas stiioepv VDRsL tbu fi ehs alos has a + RRP sode thsi kmea a PF ssel kyl?lei dnA asol fi ehs ash mlid igteincvo tnpaeirimm uyo sllti idsscsu thiw rhe ont hre htgudear occerrt ?... +4

m-ice sThi tnieeldiyf udclo be a lsefa iipvt,seo but refobe ew twna to rneciods ti to eb a aslef ivo,pesit ew shdluo atlk ot het apneitt oatub it .ipyletarv umnAsigs that 'sit a fsale psviieot bofere nkgias eht itaetnp utoab it ldcuo ladey tratemtne fo ehr lsyi.pish se'herT a ehccna hse 'idndt awnt to sosdielc hre esaulx tyoshir ni ntfro fo her hetgdaru or beyam hes was assaebmerdr or 'ddint kihnt it swa motpiatnr ot nnAn i.mdteo ur'yeo ubaltyleos ghrti, hes only sha lmid egiivtonc ep,ratnmimi os we mtso tlfdyeieni sdohlu aktl ot teh aepttin oaeln uihtowt erh dgteurha trsif. +4

seagull Seh sha .daeiemnt She 'tsonde ehva teh aptcciay ot rteidneme rhe nwo reca /22(03 .E)MM I efel hte adrueght odlhsu avhe the wrdo no eth crea sicne andamGr keiyll eos'dtn haev the yitccpaa to rndatunsed reh tio.snac +5

sajaqua1 omrF tawh I ,mberemre tenmiaed is yaltpilcy a tominiancbo of miradipe moreym nd**a aimirped othtguh srcsoeep.s Teher is onhngti to nidcieta ttha hte tenitpa hsa airepimd tguthho ssosc,pree adn teh yomerm tpmirmanie si lyno dl.im The inetpta acn lltsi ralynosabe aisd ot be tteemocpn, and so her avrptei aonoimitfnr uoshld be dsidusces twih erh noael. +12

yotsubato redEl race smeoh or lrdyeel mumseiintoc uallayct have a ihhg ater of sT.SD srTnu uto, nhew uyo ptu a chubn fo edriwvddcwoe/dio tudsal eogtehrt in a omntmiuyc heyt evha x.es +12

yotsubato adl,iAldtoyin uyo ohduls secprte het rayvpci fo a eptenmtco dautl tihw "liMd eomm"yr iaemnt.mpir I oknw I lcudo heva idml omryem ampmietrni ieginrdnosc teh capr I ortfge usntdgiy rfo tpse 1 +14

drdoom elas@ugl meeanidt ≠ ebceans of cocetpneme -- eht wot are eptraeas noepctcs adn vhae to be udleavate lntdyeepi.ednn ese 0mnb4:oie7.pmns.vrs0/hDlg/uc3rh0o/?/uiht.ti=ed nda ?.1/iilupno/r6ch.s73i/:togh0ubhvD4em/=tsenmrd. +3

wowo oals tioprmnta ot ,oetn d) apeerdet tetss si osla reitnoccr as hte oinmtgocemauihaigtrln saysa si a crtaorimfnoy etlronmpea etts olnga( the same iesln sa BF-A)TAS 9agl3r5h-/trfwhsh/mtpuita.oh/l/he:ewowb.ry8ahwtl +5

sunshinesweetheart lo...a.s I ktihn ew can esusma htta aeet"edrp es"stt mnase etraep LDRV, ton ddlnaati"oi stest ot urel otu sfela t"poisiesv +2

imtiredofstudying het eteinr pinto fo hits sqteuoin si thta whne ouy ees na TSD in na eexutnedcp adcgephrimo hlc(id,rne dl,rylee) NHIKT AELUXS ABESU +

23 of 30 is mild dementia by DSM V , still has capacity to answer basic questions , and STD in childs and elderly ALWAYS think ABUSE FIRST

+2/- usmlecrasherss(27)

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submitted by ahd_ve(7)

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het anim lgao for isht euqtisno si idvoa isigsuscdn siesus htwi eavirslte thuiotw het pi’etntas .rmneisopsi tbu omes epople erew yepedl odkehcs to ees thta a nodrhgtream ahs hsylispi. Bwt I eealv a nkil fo a seecahrr btoua ilCniacl tiilUty fo hte MtaMin-ilen Stauts mxanoanitiE henW ensssisgA ancenisi-igoMDk yiapc aCt.l9s7hs4a.e1:928/89g31n0bcoa.p70dmju.1/bopa7/7/tri/012u7so8t/s

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submitted by komodo(4)

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I tnikh eno of hte sncisofonu ehre is tath eth ogcuitagoaiminnrtlhme aysas ot'send syeiclseanr taendici tucenrr tncniefoi hwti ,ylihpiss eusaceb eomaenprlt tests cna stya eisvopit enve fro rseay trfae enaretttm (2t/Mwohi/.m:wg5pl0.bps/.lrs/c0c9imvhnw/20natc.CiP/tent h)Ta ni ocbmo ihtw het yevr lwo RRP tteri lucdo intcdeia eedatrt hpiys.sli So laryel eht tbse gthin ot od duwol eb to ask eth niptaet ryitedcl tbuao ti orefbe ouy sweta eimt ognid bipslosy aressyuencn tgeinst dan( I wolud einledifty ska her ctlireyd iescn omst popeel n'dot atlk botua ihtre SITs htwi ethir )ichdelnr

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submitted by ∗deathbystep1(21)

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ooipnt B) et(h ctcroer poiton as epr be)nm e:th entaipt sah a iinm lantem seatt fo 2/303, so tath hluods mnae ttha hes nst'i pabalec of mgikan reh own !oesindcsi so thaws het itnop ni kgnialt ot hre tlavyripe ttwiuho her tahue?rgd

iopotn )A is nowgr bceause you acnt ustj edhi the dsniaoigs form het eanttpi and rhase it twhi hte aymifl

iptoon C am&;p oy)Du tncnoa rrgedsadi teh etst or teeapr het sett sa bhto hte etst rea oe,iipvst PRR is a ecnigersn etts wtih ssel tseyciiicpf but orliggmotiaeimuchannt is a yhhgil iepcicsf etst so hse nfydetile sah pisl!shyli

onipot )E tendos ekam nsese bscuaee ywh uwlod oyu od ubmarl enpuurtc for ?lsis!ihylp

i ikthn yhte torgfo ot vegi an oitpno )F ujst fieakrn treta hre fro ph!s!il!sily

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saturdaynightpalsy "aitPtsne hiwt cseudtspe isuihrslonpey hludso rogdeun lmuarb urtencup nad steubunsqe ,DVLR A-SBTAF do/ran PRC of blraniprceeso ilud"f per my tenos dan het inutbne amLrert terupunc si seud ot ioegansd se,yslriinuoph os stat'h tawh I tp.u +2

saturdaynightpalsy oT add to ha,tt I ddnti scheoo eht oreth ssaewrn oyu slietd ofr het msea naroses you seild.t +1

ac3 hwchi of hte nlooiwlgf is teh TENX ETSB TEPS genniam yuo ntuldwo tnaw ot pumj striagth to a brlmau uutnecpr isepcyalel hnew rehte aer awnres sieccho atth sestugg ssnciidgsu teh isgidason htwi eht penatit .rfsit If you newt to hte ocrodt nad etyh geadiosn uoy ehty ilwl cissusd shti whti uoy eorfbe gderinro dilnatdioa sie.ttgn +1

yerpderp 03/32 si aosl tjus imld igovntcei pnimreitam os I sujt otuhght esh lstil dah odicenis gimnak ltyipicbaa as /3402 si stlil rmnola +3

cbreland rAe ew dexectpe to rintprete MIC ecorss +

madamestep Mldi moryme prnieamimt soed NTO amne deaseedcr ciisindog-nakem cyp.aacti nA 38 raey odl twih na alomst lonarm ltenma usatts xmae how bmyae hsa a nwe boidnyfer ta her ginrnsu ohme rbbypoal 'olndtuw wnta reh uhrgetad to kown atht esh ash na TI.S nAd if isth is elder u,esba 'yuod slao watn ot lkta ot erh aeviltpyr to ees if sseh' fes.a oN remtat taw,h lorde asutld twhi midl itedmaen era litsl lranmo leoppe dna oyu edne ot sssase irhte kmg-caoinniedsi ytaacicp noiidcse ot siinoed.c Tish monwa otms iklyle hsa het ptiacyca ot ddicee if she tswan to gdneuro yspihlis rt.mnaetet +

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